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This study evaluates its utility for detecting recurrent aneurysms and compares automatically labeled MRI (AL-BB-MRI) with time-of-flight MRA (TOF-MRA) and digital subtraction angiography (DSA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials (patients) and methods<\/jats:title>\n                    <jats:p>For model development, the basal intracranial arteries were manually labeled in 37 3D black-blood T1W-MRI examinations from 31 patients with previously endovascularly treated aneurysms. An independent, consecutive series of 84 patients with 90 aneurysms was assessed by three readers to identify recurrences in AL-BB-MRI and TOF-MRA. DSA served as the reference standard when available.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The model achieved adequate vessel segmentation (Dice\u2009=\u20090.81). Agreement between AL-BB-MRI and TOF-MRA was in 70\/90 (78%) aneurysms. Major recurrence rates were similar: 16\/90 (18%) aneurysms on AL-BB-MRI and in 14\/90 (16%) aneurysms on TOF-MRA. Discrepancies were most common in anterior communicating aneurysms (seven seen only in AL-BB-MRI) and basilar artery aneurysms (five only in TOF-MRA). Compared to DSA (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200922), AL-BB-MRI had similar accuracy (73% vs. 77%), sensitivity (62% each), and specificity (79% vs. 86%). AL-BB-MRI and TOF disagreed in nine aneurysms: AL-BB-MRI was false positive in three and false negative in two, while TOF-MRA was false positive in two and false negative in another two aneurysms.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>AL-BB-MRI showed high agreement with TOF-MRA in recurrence detection of aneurysms in the anterior circulation. Both modalities performed similarly against DSA. AL-BB-MRI was superior after flow-diverter or stent-assisted treatment but less reliable for intrasaccular flow disruption. (Level of Evidence: 5B).<\/jats:p>\n                    <jats:p>The study was registered in the German Clinical Trials Register (DRKS00014644) on 07.05.2018.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00234-026-03936-7","type":"journal-article","created":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T07:34:54Z","timestamp":1772782494000},"page":"987-996","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Deep learning-based vessel segmentation in non-contrast black-blood MRI for treated aneurysm follow-up: a comparative study with TOF-MRA and DSA"],"prefix":"10.1007","volume":"68","author":[{"given":"Samer","family":"Elsheikh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Rau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petra","family":"Cimflova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Urs","family":"W\u00fcrtemberger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elias","family":"Kellner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Horst","family":"Urbach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Reisert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,6]]},"reference":[{"issue":"3","key":"3936_CR1","doi-asserted-by":"publisher","first-page":"887","DOI":"10.1148\/radiol.10091982","volume":"256","author":"ON Naggara","year":"2010","unstructured":"Naggara ON, White PM, Guilbert F, Roy D, Weill A, Raymond J (2010) Endovascular treatment of intracranial unruptured aneurysms: systematic review and meta-analysis of the literature on safety and efficacy. 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Speaker Honoraria for Penumbra. Travel Grants from Medtronic, Microvention. AR: no competing interests. PC: speaker honoraria from ESMINT. UW: no competing interests. EK: no competing interests. HU: honoraria for lectures from Bayer, Biogen, GE, Eisai, Mbits, Lilly, is supported by German Federal Ministry of Education and Research, and is coeditor of Clin Neuroradiol. MR: no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}